Retinal vein occlusion

Retinal vein occlusion (RVO) frequently presents as sudden, painless, unilateral vision loss. Most affected patients are aged >65 years.

Hypertension, diabetes mellitus, atherosclerosis, and glaucoma are major risk factors for the development of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) in older patients.

Hypercoagulability and vasculitis are important risk factors for the development of CRVO or BRVO in younger patients.

Treatment is focused on vision-threatening complications such as macular oedema and neovascularisation. For an uncomplicated retinal vein occlusion, whether it is ischaemic or non-ischaemic, management consists of close monitoring to detect complications and treatment of underlying risk factors.

Several randomised controlled trials support the use of vascular endothelial growth factor (VEGF) inhibitors and intravitreal corticosteroids for the treatment of macular oedema in CRVO and BRVO.

Retinal vein occlusion (RVO) is an interruption of the normal venous drainage from the retinal tissue. Either the central vein (CRVO) or one of its branches (BRVO) can become occluded. Uncommonly, the occlusion can occur in a vein that drains half of the retina. This is referred to as a hemiretinal vein occlusion (HRVO).[1]Romano F, Lamanna F, Gabrielle PH, et al. Update on retinal vein occlusion. Asia Pac J Ophthalmol (Phila). 2023 Mar-Apr;12(2):196-210. https://journals.lww.com/apjoo/fulltext/2023/03000/update_on_retinal_vein_occlusion.7.aspx http://www.ncbi.nlm.nih.gov/pubmed/36912792?tool=bestpractice.com ​ Characteristically, in the retina proximal to the occlusion, the affected venous system is tortuous and dilated, and there are several intra-retinal haemorrhages and retinal oedema. RVOs are usually painless, sudden, and unilateral causes of vision loss.